5 reasons why Kegels don’t strengthen your pelvic floor
A Kegel is a pelvic floor muscle strengthening exercise “invented” in 1948 by Dr Arnold Kegel.¹ Dr Kegel proposed that the trauma from childbirth weakens the pelvic floor muscles (which can be true in the immediate few weeks after having a baby), but he also concluded that the best way to strengthen these muscles is simply to repetitively squeeze them.
Let’s go over the problem with this assumption…
5 reasons why Kegels just aren’t enough
You can’t just squeeze your pelvic floor and expect it to be strong
Let’s use common sense for a second. Which other muscle in your body is strengthened by just squeezing it repetitively? Let’s take your abs, for example. Imagine you suck in your abs and let go hundreds of times a day - would you suddenly have a strong core? Nope! Now let’s take your biceps. 💪🏽 Imagine just flexing your pipes over and over again, and expecting to be strong enough to lift your 40 lbs child? Good luck!
We know this wouldn’t happen, because that’s just not how strength training works. You cannot just flex a muscle over and over and expect yourself to get strong. You have to add load, and it has to be specific, consistent and functional.
Your pelvic floor doesn’t work in isolation
Whether your goals are to:
stop peeing your pants postpartum,
decrease prolapse symptoms with lifting,
reduce leaks with jumping or running, or
have better orgasms…
You’re not just relying on your pelvic floor strength! You’re relying on the strength and coordination of your pelvic floor muscles with the rest of your body, including your arms, legs, back and core. While we may use Kegels as a very early pelvic floor connection exercise, we shouldn’t rely on them long-term, because they won’t provide adequate strength and coordination to meet movement, pelvic health and sexual health goals.
Exercising on your back doesn’t make you strong
Kegels are often prescribed while lying flat on your back or at most, while sitting in a chair. But most people don’t experience leaks, vaginal heaviness or pain when lying on their back. They’re experiencing these symptoms when they’re in anti-gravity positions when their body adds load onto their pelvic floor. Kegels while lying on your back just aren’t enough for a strong, supple and functional pelvic floor. Since life is led in the upright position, your exercises need to take that into consideration. Strength exercises need to mimic the demands we put on ourselves on a daily basis.
Practice full-body strength, coordination, balance and agility - in a variety of positions! This is what we do in my BASE Fitness Membership! I make it easy for you so you never have to wonder how to do your exercises or what the best exercises to do are. Tap the link and sign up for your first month now!
You’re stressed and carrying pelvic floor tension
Stress and trauma
Your pelvic floor and body respond to stress, trauma and PTSD by clenching or shortening. Stress also changes the way you breathe which is why chronic stress can be so damaging. Since your pelvic floor tends to clench, tense or bear down in response to mental and emotional stress, doing more Kegels can actually exacerbate your symptoms, including leaks and pain. Kegels may also make your pelvic floor feel weaker because repeatedly tensing a muscle that’s already over-clenched will lead to ineffective strength, poor function and more fatigue.
The impact of Postpartum Stress
Postpartum sleep-deprivation, baby crying, toddler whining, poo-splosions all over the carseat just before a wedding, night wakes, interfering MILs, 👀 relationship struggles, mental health challenges, aging parents, work, life, systemic racism, prior trauma… all of that can add to your overall stress. Perinatal mental health support can be vital during this time, and can be accessed in conjunction with pelvic floor physical therapy.Stressing about your pelvic floor
If I could tell you to STOP thinking about your vag, would you? I know, it’s easier said than done, right? The problem is: stressing about your pelvic symptoms can cause more pelvic floor clenching. When you spend too much time tensing your pelvic floor muscles, they become functionally weak. Imagine your fist has been tightly closed for hours, and then you go to lift a heavy jug of milk - your hand will feel super tired, weak, and may cramp. You may even have trouble pouring the milk. The same thing can happen with your pelvic floor when it’s chronically clenched. It may be too tired or weak to function effectively.
If you suspect you might be stressed, tight, and clenched, try pelvic floor relaxation exercises like reverse Kegels, which are detailed in my Release your Pelvic Floor e-guide.Pelvic floor mobility matters more than you think
This ties into point number 4.
Adductor rockbacks are a fantastic exercise to release tension in your inner thighs and pelvic floor
In order to have a functional and effective pelvic floor muscle contraction, you need to have adequate range of motion in your pelvic floor muscles. Picture this - open your mouth wide to chomp into a giant burger. 🍔 Now what if your jaw is stuck and you can barely open your mouth? 🥱 You’d have to take tiny microbites to get around the burger, and the “contraction” of your jaw wouldn’t be as powerful. In this scenario, doing more jaw clenching contraction exercises wouldn’t help you. In order to have a more functional jaw, you’d need strategies to open your jaw and create space.
Psst: If you actually have jaw pain or dysfunction and can’t open your mouth wide, you may have TMJ or temporomandibular joint dysfunction. See a physiotherapist. If you live in Toronto, come work with me!
When your pelvic floor muscles are tight, shortened or tense, Kegels won’t help because you lack range of motion to create effective muscular contractions. Many people with leakage and prolapse benefit from pelvic mobility exercises to help resolve excess tension in the pelvic floor prior to initiating strength exercises. I show you exactly how to relax your pelvic floor and improve your pelvic mobility in my 90-minute Reclaim your Pleasure pelvic floor workshop. It was such an incredible workshop to release shame, embrace your sexuality and release tension in your pelvis, hips and body.
But my doctor told me to do Kegels
If your OB, doctor or pelvic physical therapist told you do Kegels, they’re not necessarily wrong. If Kegels are helping you, that’s fantastic! Kegel exercises are considered the first-line therapy for urinary incontinence, after all.¹ But if you’ve been prescribed Kegels for weeks and months, and your leaks and symptoms haven’t resolved, it’s time to move on. If Kegels were going to work, they would have worked by now! You may need to try a different approach.
What about Kegel chairs? Do they work?
Shoutout to giphy for this hilarious gif
Full disclosure, I do not have any experience using Kegel chairs nor have I ever recommended it for my clients. Kegel chairs, like the Emsella chair, deliver a high-intensity focused electromagnetic wave, which induces deep pelvic floor muscle contractions at a rate of 11,200 Kegels in 28 minutes. 😳 It is proposed as a non-surgical, non-invasive treatment for incontinence, and you often see them advertised in spas and wellness clinics.
However, not all incontinence or leakage is caused by a weak pelvic floor, and repetitive Kegels can actually exacerbate leaks, sexual pain and prolapse symptoms. After all, the function of the pelvic floor isn’t to do 11 thousand contractions in half an hour, so doing that as a treatment for your weakness may not translate to meeting your functional goals. This is why it’s important to be evaluated by a pelvic floor physiotherapist to ensure the best course of action and whether something like an Emsella chair would be useful for you.
Book in with me (a pelvic floor physiotherapist) to get personalized pelvic health support!
A cost comparison: Kegel chairs vs pelvic physiotherapy + vibrators
While these Kegel chairs may sound fun, exciting and simple, remember that these treatments can cost up to $3000 for 6 sessions and may not even help you reach your goals. 😬 For comparison, a pelvic floor assessment and 6 treatments with me cost less than $1000, and you’ll get a lot more out of it than you would sitting on a vibrating chair for 30 min.😅 Add in a vibrator ($50-$200) to give yourself more frequent orgasms, and you’ll have way more fun than sitting in a Kegel chair, plus you get more pleasure and pelvic strength out of it too!² Combine both pelvic physio and more pleasure, and you get a winning combination to support your pelvic strength!
And if you can’t afford individualized care yet, grab my Pelvic Strength workshop to learn how to incorporate your pelvic floor during a full-body workout! You’ll learn strategies and exercises to improve pelvic control, confidence and stamina so you finally have the energy to get off your back during sex! 🔥
When to Kegel vs progress past Kegels
Kegels can be helpful in the early days and weeks postpartum or post-injury, but beyond that, we want to progress to more upright positions and more challenging exercises. To my pregnant, postpartum and active mamas, you need functional fitness that helps you get back to your movement goals while also strengthening your pelvic floor. Kegels are just not enough to get you back to hiking, running, jumping, dancing or even lifting your baby up all day!
Check out this graph below to see 10 exercises that are actually proven to be more effective at activating the pelvic floor than doing isolated Kegels alone!³
10 Pelvic Floor Exercises that are more effective than Kegels
Exercises like the cat-cow, bridges and squats activate and strengthen the pelvic floor muscles more than isolated Kegels, AND they’re more functional. We incorporate all these moves and more in my BASE Fitness Membership! Each 30-minute workout incorporates pelvic floor, core and full-body strength and mobility exercises. You get video instructions of each exercise with modifications to accommodate for pregnancy, postpartum or pelvic symptoms. I’ve got 3 tiers of BASE to support your individual needs, and you can try out your first month here!
Resources:
Reclaim your Pleasure Workshop to release excess tension in your pelvic floor
Pelvic Strength Workshop to learn how to connect with your pelvic floor and coordinate it with the rest of your body
BASE Fitness Membership for fitness workouts that support your whole pelvic health
Book a one-on-one consult (in Toronto or virtual appointments available globally)
References
Yi-Chen Huang; Ke-Vin Chang. Kegel Exercises. May 1, 2023. Accessed here on September 16, 2023.
Alexandra Dubinskaya, Rainey Horwitz, Poone Shoureshi, Jennifer Anger, Victoria Scott and Karyn Eilber. MP38-16 Is it time for FPMRS to prescribe vibrators? Journal of Urology, Volume 207, Issue, Supplement 5, May 2022. DOI:https://doi.org/10.1097/JU.0000000000002592.16
Bruce Crawford. Pelvic floor muscle motor unit recruitment: Kegels vs specialized movement. Oral Poster, Volume 214, Issue 4, Supplement S468, April 2016. Accessed here on September 16, 2023. DOI:https://doi.org/10.1016/j.ajog.2016.01.033
